Prithvi Gupta, 30-year-old assistant editor at a leading publishing house in Bangalore, had been having trouble conceiving - her hormonal profile was borderline normal and she had put on a few kilos too many since her college days, but her gynaecologist reassured her that it was not cause enough for worry, just a matter of time. When she finally got a positive on the dipstick after seven months of trying and fretting, she was over the moon and meticulous about taking all her hormonal and nutritional supplements, eating well and getting enough fresh air.

Then, at the beginning of the third month, a routine ultrasound saw her doctor turn a grave face to her. 'I'm not entirely happy with the foetal heartbeat,' she said, and Prithvi's own heart skipped a beat. 'I want to go over check your hormone profile once more, just to make sure… And let's check again in a week.'

The tests were done; but before the results were in, the young mother began bleeding - and lost her baby. 'Spontaneous abortion, 'her doctor's report read, and it was another month before a heartbroken Prithvi could bear to see her gynaecologist again to ask that crucial question: 'What had gone wrong?'

Investigation showed she had been word-perfect on her prescriptions. Her gynaecologist shook her head sadly in defeat: The first-time mom-to-be had thought as long as she ate well and took her pills, she didn't really need to worry. But, her ever-so-slightly hormonally challenged body had been unable to provide her baby with enough folic acid to sustain the pregnancy. Folic acid was one of the crucial components of the multivitamin pill Prithvi had been taking since the day she knew she had conceived. However, she had neglected to fill the prescription when she began trying, as she figured on getting her nutrients in order once there was a baby to worry about - but the foetus' nearly development had been hampered already, before that confirmation came, in those first couple of weeks.

Next time her gynaec had Prithvi on the pills as soon as she was ready to try again and monitored her closely before giving her the go-ahead. Three months later, she was pregnant again. Nine months after that, she gave birth to little Akanksha.

Get Savvy Before Baby

Even as she dandles Akanksha on her lap, though, Prithvi can't quite forget her brother-who-never-was. Of course, Prithvi's was a special case in that her body didn't function quite as optimally as it might have.

However, a home truth often missed by both grandmothers and today's health-conscious mothers-to-be: Perfect health and optimal nutrition for mom must begin even before baby is a mere twinkle in her eye.

Moreover, nowadays doctors recommend that for women who are otherwise healthy, a better diet is more important than nutritional supplements in pill form, with the exception of iron, which most women are low on, even if it isn't low enough to be clinically labelled a deficiency.

Dr. Michael Hambidge, professor of paediatrics and director of the Center for Human Nutrition, University of Colorado, Health Sciences Center explains  in his introduction to health writer Bridget Swinney's book Eating Expectantly why you need to have a proper diet before you are pregnant. According to him one of the most important reasons for selecting an optimal diet rather than a pill is the fact that prenatal vitamins are not prescribed until the first prenatal visit to an obstetrician.

He feels the trouble is, most women only get to their doctor when they figure they might be pregnant - and often, as they await confirmation, the critical first week's of baby's development have gone unsupported by these health-boosting measures.

We know, for instance, that we need to take folate or folic acid because it has a critical role to play in the correct development of a child's nervous system . However, as Dr. Hambidge points out, that extra folate must be taken not only in the first weeks of pregnancy, but prior to conception!